When you make a car insurance claim after a car accident, the insurance company employee who's in charge of settling your claim is typically called an "adjuster." In this article we'll cover:
- the adjuster's role in the context of a car insurance claim after a crash
- steps the adjuster will take to investigate, valuate, and settle your car insurance claim, and
- how you can protect yourself and maximize your claim when dealing with an insurance adjuster.
What Is an "Insurance Adjuster"?
An insurance claims adjuster is the insurance company employee who is charged with investigating the facts of a car accident and negotiating a settlement of a car insurance claim.
In the insurance context, the word “adjust” means to determine or settle a claim or to assess a loss or claimed damage. In investigating a claim, your lawyer (if you have one) and the insurance adjuster are both doing the same things; they're trying to figure out what happened and what the claim is worth.
Whose Insurance Company Does the Adjuster Work For?
After a car accident, an insurance adjuster might handle a claim filed by either:
- a driver who wants their own car insurance policy to cover car accident-related losses, under specific kinds of coverage, such as uninsured/underinsured motorist or personal injury protection coverage (for car accident injuries) or collision coverage (for vehicle damage), or
- a person who was injured and/or had their vehicle damaged and wants to hold the insurance company's insured driver responsible for accident-related losses; this is known as a "third party" car insurance claim, and it's filed with the insurance company of the at-fault driver, under their liability coverage.
For purposes of our discussion, let's assume you're making a third party car insurance claim, so you're dealing with an adjuster for the other driver's insurance company.
The Adjuster Will Find Out What the Insured Driver Says
Once an insurance adjuster is assigned a claim, the first thing they'll want to do is to get their customer's (their insured driver’s) version of the facts.
The adjuster will:
- read any written accident report submitted to the insurance company (if the customer filed one), and
- often call up the customer to hear their story firsthand.
Learn more about contacting your car insurance company after a car accident.
Of course, experienced adjusters understand that their customers aren't always telling the truth. Good adjusters know when to make judgment calls on their own insured drivers' believability.
The Adjuster Will Request Official Records
The adjuster will then request the official records—including the police report and any accident-related reports the drivers filed with the state department of motor vehicles, if such documents exist.
The Adjuster Will Respond to Claims Filed Against the Insured
The first email or letter to the claimant (or to the claimant’s lawyer) is usually generic correspondence that:
- identifies the adjuster
- provides the applicable liability coverage limits (if the accident occurred in a state that requires the insurer to provide these limits)
- asks the claimant or the lawyer to sign or provide an authorization for the release of medical records related to the car accident, and
- requests all other documents relating to the claimant’s "damages" (which means compensable losses in the language of the law, including proof of earnings, and vehicle damage-related records (like vehicle repair estimates).
The adjuster will likely have already investigated you by this time! Insurers have various claims databases they can access to determine whether you've filed a personal injury or property damage claim before. The adjuster will likely do a quick online investigation too. They'll want to know who they're dealing with and also want to dig up any dirt they can.
The Adjuster May Ask for a Recorded Statement; Don’t Give One
Insurance adjusters will usually ask that a claimant give a recorded statement describing the accident and their injuries. As a general rule, giving such a statement in a car accident case won't help you, especially if you don't have a lawyer, and you absolutely don't have to give a recorded statement to the adjuster.
The Adjuster Will Determine the Value of the Case
Once the adjuster has all of your medical records and bills and all of the other information that they'll need to assess how much your car accident claim is worth, they'll put a dollar value on the claim and try to settle it.
Keep in mind that the insurance adjuster's job here is to do everything they can to minimize the value of your claim and get you to accept as little as possible in order to close your file.
If you don’t have a lawyer, the adjuster will generally ask you how much you want to settle the case. Don’t give a number first. Ask the adjuster how much they'll offer to settle. Now you're in the negotiation stage of your claim.
If the adjuster's first settlement offer is too low—and if you don't have a lawyer, it will almost certainly be an unreasonably low offer—you can put together a formal demand letter in which you:
- describe how the accident happened, including why the other driver is at fault
- detail the nature and extent of your injuries (including any diagnoses you've received) and your course of medical treatment (while itemizing the cost of that care)
- list the financial effects of the accident and your injuries, including time missed at work and other economic losses
- describe how the car accident and your injuries have affected your life, including your physical and mental "pain and suffering," activities you've been unable to do, and other impacts, and
- demand a certain dollar amount to settle your car accident claim.
Getting Help Dealing With the Insurance Adjuster After a Car Accident
Maybe you've tried negotiating a car accident settlement on your own, but the adjuster just doesn't seem to be taking you or your claim seriously. Perhaps the adjuster is pushing back on a key issue related to your car accident claim—like who was at fault for the accident, or the legitimacy of your injuries or medical treatment. In most instances, putting your car accident case in the hands of an experienced legal professional is the best way to ensure a fair result.
Learn more about when you might need a car accident lawyer.